The prognostic value of combined smoking and alcohol consumption habits for the estimation of cause-specific mortality in middle-age and elderly population: Results from a long-term cohort study in Lithuania

Aim. To evaluate the prognostic value of combined smoking and alcohol consumption habits for the estimation of cause-specific mortality risk in middle-age and elderly population. Methods. The study presents data from the four surveys. A random sample of 6,729 subjects aged 35-64 years was selected for statistical analysis. During the follow-up of 31 years (1983-2014), there were 2,158 deaths from any cause. Multivariate Cox's proportional hazards models were used to estimate hazard ratios (HR) for all-cause mortality and Competing Risk Regression analysis was used to estimate subdistribution hazard risk (SHR) for cause-specific mortality. Results. Smoking clearly increased the risk of all-cause mortality and mortality from cancer and cardiovascular disease (CVD), but alcohol use had little effect in men aged 35-64 years. However, heavy alcohol consumption (>14 units/week) increased the risk of all-cause mortality and mortality from external causes in the never-smokers men group who drank alcohol of 1-14 units/week (HR 2 = 1.57 and SHR 2 = 2.40, resp.). Conclusions. The smoking habits and alcohol consumption are modifiable risk factors, and thus efforts to support abstinence from alcohol and smoking use should be a public health priority.